Often times I hear complaints about an ACA Marketplace Plan stating that it did not cover an OBGYN visit. The question that comes is, “I thought these visits are covered because of Obamacare?” The short answer is, they are. However, there are some rules that you need to know about regarding whether or not a visit is covered as free/preventative under the Affordable Care Act.
Mammograms are only covered for women who are over the age of 40. Pap smears are covered once every three years for women 21-65. These are not covered for everyone or every year.
It is important to know and understand what is or is not covered under the Affordable Care Act before you go to the doctor so you are not surprised when you receive a bill. Insurers may elect to cover these services for a broader range of customer and more often, but these are the minimum requirements.
For more information, visit healthcare.gov
December 11, 2018
Mount Hermon, KY – David Taylor Jr. has been recognized for his hard work and expertise in helping consumers enroll in and manage qualified health coverage through the Health Insurance Marketplace.
This nationwide recognition from the Centers for Medicare & Medicaid Services (CMS) as a member of the 2019 Marketplace Circle of Champions highlights David Taylor’s success in enrolling consumers during this Open Enrollment Period.
“Consumers turn to agents and brokers for trusted advice and guidance in selecting plans, enrolling in coverage, and managing their health insurance policies throughout the year,” said Randy Pate, Director of Center for Consumer Information & Insurance Oversight (CCIIO) operation within CMS, which oversees the Marketplace. “We thank David Taylor for his hard work and exceptional service in helping Americans get coverage.”
The Marketplace Circle of Champions program recognizes the hard work, expertise and service of Marketplace-registered agents and brokers. Agents and brokers large numbers of consumers qualify for the Marketplace Circle of Champions.
Eligible consumers can enroll in Marketplace coverage during this year’s Open Enrollment Period, which runs November 1 – December 15, 2018. Consumers with questions about their coverage or who would like help enrolling, can contact David Taylor at 1-888-630-3826.
The ruling has not placed an injunction on the current market so nothing changes yet. We are still monitoring the situation. There will likely be an appeal process. Any updates will be reflected on our updates page.
We are aware of the news that dropped moments ago that a federal judge has ruled the Affordable Care Act, known as Obamacare, to be Unconstitutional and invalidated.
We do not know any details of how this will impact health coverage for 2019 at this time. We will update you as soon as we know something more.
For the last few years short-term health insurance plans have only been allowed to last for a maximum coverage period of three months. This decision forced many families into overly expensive health plans in the Healthcare.gov Marketplace.
On October 2nd all of that changed. These plans are now allowed to last for one year just like any other medical plan. This means that you have more options, more networks, and often better prices to choose from.
This, combined with the elimination of the ACA Tax Penalty for not having insurance, means that now is the best time to buy insurance for you and your family.
Please request a free quote today to find out what your options are!
Understanding A Copay
Some insurance plans offer a type of office visit payment called a copay. This term can be confusing as it does not mean the same thing every time.
Typically, a copay is the amount that you are required to pay to be seen for service. That part is easy to understand. The difficult part is whether or not the copay is all you will pay for the service that you are receiving.
Some insurance plans waive the deductible in favor of the copay. That means you do not have to meet your deductible and only have the copayment and any applicable coinsurance. However, many plans require a deductible before you get to pay a copay. This means if your office visit is normally $100 and your copay is $20, you would have to pay the full $100 if your copay has not been met.
Are Copays Right For Me?
The question of whether or not a plan with a copay is right for you depends on what you want your out of pocket costs to be for the year. Typically, plans with copays are higher in monthly premiums. However, your upfront costs for medical services may be cheaper.
This is not a question that is easy to navigate on your own. Our team is available to help explain the plans that you are looking at and to help you decide what plan will give you the best coverage at the best overall prices. Schedule a call today or submit a form to get a free quote.
It is true that the recently signed into law tax bill does remove the individual mandate from the Affordable Care Act. However, this repeal of the mandate does not go into effect until 2019. This means that you must still have minimum essential coverage for 2018 or face the possibility of a tax penalty.
So what exactly does this mean?
For 2018 you must have minimum essential coverage in order to avoid the tax penalty. There are still ways to do this and you can get a quote by contacting our team.
In 2019, options will change drastically. You will be able to obtain insurance of any type without the fear of facing a tax penalty or can even opt to go with no coverage at all.
If you have questions about this, want to know your options, or have general questions about healthcare, feel free to contact my team today.
H.R.1 — 115th Congress (2017-2018)
If you have missed the open enrollment period for the Healthcare.gov marketplace that does not mean you cannot get insurance coverage for 2018. There are many options to get coverage for the New Year, including avoiding the 2018 ACA Penalty.
Because you missed the deadline you do not have as many options and will not be eligible for a subsidy but you can get affordable coverage by contacting an agent/broker to assist you with a plan.
Our company has plans available that will satisfy the ACA law requirements for coverage and get your comprehensive coverage for the 2018 plan year.
Get a quote today!
One of the most confusing pieces about healthcare are prescription medication costs. The Affordable Care Act made stipulations on drug coverages that are almost impossible to understand, and not all carriers are uniform in the way they present their drug tiers.
Here is what you need to know:
For each type of drug you are either going to have a copay, deductible, or coinsurance. In some cases you may be paying full price regardless if you have insurance.
These prices can often be beat, depending on the drug and insurance carrier, by a prescription discount card.
How do you use the card? It is simple. Every time you get a prescription, tell the pharmacy to run the discount card and your insurance carrier and give you the cheaper of the two options.
Prescription discount cards can sometimes save up to 85% or more on the cost of the medication which can save you hundreds of dollars throughout the year.
To get a free discount card, go to the link www.davidtaylorjr.com/rxcard
2018 Open Enrollment is in full swing and everything is running smoothly so far. It is not too late to get coverage for 2018 but time is running out.
Open Enrollment was cut from 90 days down to 45 days this year and ends on December 15th in most states. There is also no word on when changes will be made by CMS and HHS regardign the Executive Order the President signed in October.
That means, if you want a solution that is long term you need to act now!
The problem is that deductibles are high with the ACA plans for many Americans. That is ok, you can get a supplement to offset those costs.
Feel free to contact us to get a quote today!
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It is finally here, Open Enrollment 2018!
Tomorrow you will be able to enroll for insurance plans under the Affordable Care Act for the 2018 plan year. Here is what you need to know:
- Open Enrollment lasts from November 1st to December 15th in most states.
- Premiums have increased in most areas. We have actually spoken to consumers who have been told their premiums are increasing by 50%.
- Deductibles are also going up.
There are ways to offset these new costs or eliminate them altogether. However, you will need a licensed agent to help you navigate these changes.
Our team is standing by and ready to assist you with these changes. Please call 1-888-630-3826 or schedule an appointment.